Doctors treat men and women differently when it comes to pain - women in hospital have to wait longer to be seen and are less likely to be given pain medication than men, a study comparing how pain is perceived and treated in male and female patients shows.

The results, published on August 5th inProceedings of the National Academy of Sciences, highlight how unconscious biases can influence our perception of others' pain experiences.

“Women are seen as exaggerating or hysterical and men are seen as more stoic when they complain of pain,” says co-author Alex Gileles-Hillel, a physician and researcher at the Hebrew University of Jerusalem.

Minimize female pain

Gileles-Hillel and his colleagues examined the extent of this bias in emergency rooms at Israeli and U.S. hospitals. They analyzed more than 20,000 discharge notes from patients who came in with “non-specific” pain complaints – such as headaches – with no clear cause.

The analysis found that when they arrived at the hospital, women were 10% less likely than men to have a recorded pain scale of 1 to 10, which is given by the patient and provides doctors with an indication of pain intensity. According to the initial assessment, women waited an average of 30 minutes longer than men to see a doctor and were less likely to receive pain medication than men. This trend was independent of the gender of the nurse or doctor. “Women can have the same stereotypical views about women’s pain as men,” says Gileles-Hillel.

Researchers also tested how 100 health care professionals perceived patients' pain. Participants were presented with a scenario of a patient with severe back pain and the patient's previous clinical information was given. The patient profiles were identical except for gender. Participants consistently gave higher pain scores for the male patient than the female.

"One of the reasons we see this in the pain area is that there are no objective measurements for pain, so the doctor has to rely on the patient's reports. That allows for more bias," says Diane Hoffmann, a health care researcher at the University of Maryland in Baltimore. She adds that the topic should be highlighted during medical training to equip doctors with a better understanding of pain and the potential for bias in treatment.

Another immediate solution Gileles-Hillel wants to test is checking whether using computer systems to generate memories is enough to improve fairness - for example, an alert could advise a doctor to prescribe painkillers if a patient has reported a high pain score, regardless of gender. “Doctors are not aware of these biases,” he says. “Raising awareness is one solution.”